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How Probiotics Win the Battle for a Healthy Mouth

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Your Oral Biome and the Benefits of Oral Probiotics

Most people are now familiar with probiotics – friendly bacteria that are advantageous for systemic health (digestion, cardiovascular health, fungal management, vitamin production).

Probiotic bacteria aren’t only for the digestive system, though. The biome in your mouth also contains different beneficial probiotic bacteria that keep the detrimental bacteria at bay. These probiotic bacteria compete with the detrimental bacteria for space in the porous tooth surfaces and in the gum pockets between your teeth and gums.

Tooth decay and cavities are the most prevalent chronic infectious diseases in the world. Dental caries (cavities) and bleeding gum-lines point to gingivitis and even bone loss (periodontitis) caused by persistent, harmful and sticky detrimental bacteria.

We now know that oral disease affects more than your teeth and gums; it also impacts systemic whole body health as well. WebMD reports that “a growing body of research finds that bacteria and inflammation in your mouth are also linked to other problems, including heart attack and dementia, and may well jeopardize your overall health.”[1]

 What is Periodontal Disease and Tooth Decay?

More than 90% of the global human population, including 75% of adults in the United States, has some form of periodontal disease, which is caused by a sticky layer of bacterial biofilm in the mouth (oral cavity) and is characterized by a spectrum of symptoms and severity. Obvious symptoms such as bleeding or sensitivity of the gum-line are red flags that your oral health is in jeopardy. Other symptoms that may be less noticeable to the public include receding gums, bad breath and loose teeth. However, knowing which symptoms to look out for and how to manage them may be tricky.

A lack of proper management and treatment can lead to tooth decay. When bacterial biofilm has not been removed for about ten days, plaque on the surface of your teeth and gum-line can turn into hard mineralized tartar that is difficult to remove except by a dental professional. Over the long term, lactic acid produced by detrimental bacteria wears away your tooth enamel and dentine, creating cavities (or caries). In addition, your body’s immune defense systems attack these pathogenic bacteria as well as the tooth surfaces these bacteria are on, leading to tooth decay and even tooth loss, particularly of anterior teeth.

 A Link Between Oral Health and Systemic Body Health

How does poor oral health reach beyond the mouth? Bacteria in oral biofilm can pass through diseased gum tissue, then enter the bloodstream and travel throughout the body. The same sticky bacterial plaque then attaches to surfaces inside your blood vessels. Plaque’s irregular shape and sticky property trap materials passing in your circulatory system. This structure continues to grow over the long-term and eventually blocks your blood vessels partially or completely, thus not allowing flow of blood, oxygen, and nutrients through the vessels, quickly causing tissue death.

Alternatively, the site of plaque growth may cause a tear and leak in the blood vessel. Its lining may become distended, or fill with pooling blood that also blocks circulatory flow, or rupture completely. This type of blood flow block occurs more commonly in the aorta, brain, spleen, intestines, and knees. Consequently, an oral-systemic association may lead directly to cardiovascular disease. 

Chemistry of Oral Bacteria: Friendly Versus Harmful

Many bacterial species have a sticky capsule coat made of a polysaccharide that helps bacteria adhere to surfaces such as teeth. Glucose, which we consume as an energy source, is used by bacteria as well. The major difference is that bacteria carry out fermentation, which yields a waste by-product called lactic acid (or lactate). As you can imagine, your mouth, with constant food intake, is an ideal living incubator for these bacteria. Consequently, your mouth and teeth are full of acid as well. With each meal that we enjoy, countless bacteria are thriving and churning out more and more acid that is harmful to your teeth. 

How Can You Successfully Manage Harmful Oral Bacteria?

Most of us grew up learning to manage bacterial “plaque” with traditional methods of mechanical brushing and flossing to remove food debris from tooth surfaces, between teeth, gums, and the tongue. Newer versions of these standard methods include electric-powered brushes and water irrigation.

Chemicals can play a supplemental role in breaking down food debris and killing off oral bacteria. Mouth rinses often have breath fresheners to mask acid production and fermenting food debris in the mouth. Some rinses also contain close to 25% alcohol to kill bacteria. Other rinses are designed specifically to reduce and prevent tartar, caries and tooth sensitivity.

General spectrum antibiotics also kill off bacteria and reduce plaque by preventing formation of a cell wall in bacteria, thereby reducing their proliferation. Sodium bicarbonate (baking soda) is alkaline and often is used to counteract and brush away acidic plaque. All of these remedies attempt to kill, dislodge or destroy the environment of all bacteria indiscriminately, both harmful and beneficial. 

The Discovery of Oral Care Probiotics

Researcher Dr. Jeffrey D. Hillman, working at the Harvard-affiliated Forsyth Institute in Boston and later at the University of Florida Dental School, conducted landmark research in oral microbiology, especially as it relates to bacterial interactions in the oral biofilm.  Hillman’s hypothesis: If everyone has detrimental bacteria in their mouths, why doesn’t everyone have serious tooth decay and periodontal disease? What is balancing the impact of these detrimental bacteria?

Hillman collected biofilm samples from people with healthy teeth, from different parts of the mouth epithelium and palate, tongue, tooth surfaces, plaque, and tonsils, eventually identifying more than 700 species of bacteria.

Among those hundreds of pathogens, Hillman discovered, were a small number of natural strains that do not produce lactic acid. These friendly bacteria naturally compete with harmful acidic bacteria for resources as well as space on tooth surfaces and gum pockets and can actually play an important role in maintaining the micro-ecological balance in the mouth.

Dr. Hillman realized that if we can increase the number of these friendly oral bacteria, they would reduce the number of harmful acidic bacteria greatly. Hillman proposed a novel approach for controlling the harmful effects of oral plaque build-up: augment the host on a regular basis with beneficial bacteria.

Eventually, Hillman isolated three particular bacterial species of human origin that, in sufficient numbers, could crowd out the harmful bacterial: Streptococcus Oralis strain KJ3 and Streptococcus Uberis strain KJ2, and Streptococcus Rattus strain JH145. All three strains are from the generally non-pathogenic group of bacteria known as Streptococcus viridians.

The First-of-Its-Kind Oral Care Probiotics

Those friendly bacteria are the strains that comprise ProBiora3, the active ingredient in the ProBiora Health family of oral probiotics. ProBiora3 is a probiotic blend in the form of a small, dissolvable mint tablet containing all three natural probiotic strains for beneficial oral health discovered by Dr. Hillman. ProBiora3 is the first-of-its-kind oral care probiotics to offer an effective addition to the ways we manage oral care and control the nasty bacteria.

Cosmetic Whitening Effect

Whitening teeth is one particularly interesting benefit of ProBiora3. One of the probiotic strains in ProBiora3 naturally produces hydrogen peroxide instead of lactic acid. Hydrogen peroxide is a well-known antimicrobial agent against anaerobic bacteria, including those that thrive at the back of your tongue (Nagelberg 2015). This hydrogen peroxide-producing strain has been tested for a whitening effect, significantly reducing stains in comparison to control groups. It also continues to be active at the four-week study endpoint. This mechanism of cosmetic tooth whitening eliminates the side effects of popular but harsh treatments such as bleach or abrasive polishing agents.

Other Health Benefits of ProBiora3-based Oral Care Probiotics

In addition to tooth whitening, the health benefits of consuming oral care probiotics include reducing anaerobic oral bacteria that produce ill-smelling sulfur and bad breath. Friendly bacteria may also increase the help with reducing inflammation, stimulating immunity and promoting bone formation (and thus bone density).

Summation: Supporting Your Oral Health Naturally

Inside our mouths, good and bad bacteria constantly battle for space and domination. Today’s lifestyle habits don’t always contribute to the “good” side. Our oral balance can be periodically disrupted by such factors of modern life as stress, disease, antibiotics, unhealthy food and poor dental hygiene practices, as well as harmful environmental conditions. 

A healthy mouth may be maintained with a population of friendly probiotic bacteria. According to the American Academy of Oral Systemic Health, “an ideal ratio within the human body is 80% beneficial bacteria and 20% opportunistic (pathological)” (AAOHS website 2017).

The ProBiora line of probiotic products are designed to outcompete and outnumber harmful acidic bacteria that produce sticky plaque and promote tooth decay. The novel engineered oral probiotics created by Dr. Jeffrey Hillman and now available in ProBiora oral probiotics have been shown to produce antiseptic properties targeted at dental pathogenic bacteria. An additional cosmetic benefit is that the probiotics have a significant whitening effect. ProBiora oral probiotics offer a simple, easy-to-use method for supporting oral and system health.

The ProBiora line of probiotic products represents a natural approach for dental health maintenance between office visits. As an adjunct to any professionally recommended home oral hygiene regimen, these products are especially suited to patients in maintenance, those with poor home oral care compliance, or any patients with special challenges because of physical impairment or salivary flow problems. Incorporating ProBiora oral probiotics into one’s existing home oral care practices can be a potent weapon in promoting healthier gums, white teeth and fresh breath.

Note:  Dental professionals should seek out peer-reviewed articles supporting the safety and effectiveness of a product for its intended use. The three strains in ProBIora3 have been the subject of more than 15 publications in the past 25 years, and the results of the most recent human trial are reported in the Journal of Applied Microbiology. The safety of the ProBiora3 active ingredient has been well established for oral applications.


[1] Michael Friedman, DDS, “Dangers of Plaque & Gingivitis to Your Health,” WebMD Medical Reference,, November 29, 2015,

American Academy for Oral Systemic Health. 2017. Website. Accessed October 2017.

Haskin, S. 2011. The loss of a thoroughbred. Hangin’ with Haskin. Blog. 07 July 2011.

Hillman, J.D., E. McDonell, C.H. Hillman, and M. Handfield. 2016. Dental whitening effect of an oral probiotic. Dental, Oral and Craniofacial Research. 2(1):202-205.

Nagelberg, R.H. 2015. Oral probiotics. Dental Economics.

Nosti, J. The next weapon in cosmetic case protection and oral health. December 2010.

Snyder Sachs, J. 2008. This germ could save your life. Popular Science. January 31, 2008.

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